36F , 130 lbs , 5'5" , previous smoker (haven't smoked in 5 years)

I’ve been peeing excessively at night for years now. It’s so bad, I will seriously pee 10 times an hour, only at night, just before I go to sleep. I don’t have a problem with my urination during the day. It’s only at night. During the day, I can hold it for hours and hours. Once I fall asleep, I can again hold it for hours and hours. It appears to be only just BEFORE I fall asleep, that I feel the urge to excessively urinate.

It seems like at night, my bladder gets so sensitive and overactive, that when I’m lying in bed, even if there is a tiny bit of urine in there, I will feel like this immense urge, like I HAVE to expel it. And then when I get up to go to the toilet, I push and push and a tiny trickle comes out. And even if I have peed 5 to 10 minutes earlier, another trickle will *always* come out. It seems like I am unable to fully expel my bladder completely at night, for some reason. Why is this happening to me?

I visited a urologist 3 or 4 years ago, who conducted a series of medical exams on me. She ruled out UTI and STDs and STIs as a possibility. She stuck some sort of camera inside my urethra and deduced that nothing was anatomically wrong with me. She sent me to a physical therapist, who stuck some sort of machine inside my vagina to test the strength of my Kegel muscles (I had no idea such a machine existed prior to going to the PT). But apparently I maxed out the machine, so the PT said that my Kegel muscles are not weak in the slightest. She said my Kegel muscles are, in fact, very strong. Yet, for some reason, I still can’t stop peeing at night.

The only thing the urologist said was abnormal is the fact that there are red blood cells in my urine every single time she does a urinalysis tests. I distinctly remember my parents telling me that I always had traces of blood in my urine, even when I was a child. Because of this, I always get false positives for UTIs. But later on when a culture test is done, it turns out there was no bacterial growth, and therefore no UTI after all.

When I asked the urologist why this happens, she simply shrugged and told me it’s normal for some people. She said that some people’s kidneys or urinary systems simply don’t filter out the blood correctly. She never gave me a discernible explanation. She never gave me any indication that it’s cause for alarm or concern, so I just accepted her explanation and forgot about it.

Edit: Forgot to add that every time I’ve had an ultrasound done right after urinating, it’s noted each time that I still have a little bit of urine in me. For whatever reason, I am unable to completely expel everything from my bladder.

She prescribed me 2 pills (hydroxyzine and oxybutynin) to help with the issue, but those also come with their own side effects. Namely, both give such a strong hangover effect, and it's very hard for me to wake up the next morning without feeling groggy. And while hydroxyzine is the most effective medicine for chronic urination, but it also gives me chronic nightmares. I have intense, vivid nightmares -- serious nightmares -- that I'm getting murdered or kidnapped. It causes me to wake up in night sweats and night tremors. Because of that, I would prefer not to take any medication, if I can help it. I also don't see medication as a long-term solution to this problem.

Is there maybe another medical reason that could explain why I pee so excessively at night? This is seriously driving me crazy at this point.

Edit: I should probably add that I don't drink fluids for at least 2 hours before bedtime, upon the suggestion of my urologist. While this has helped somewhat, I still feel that I am urinating excessively just before bedtime.

Edit: I forgot to add one more thing. I noticed when I have the urge to pee, it’s almost always when I’m lying on my back. If I roll over and switch to lying on my side, it goes away. When I roll onto my back again, I feel way more of an urge to pee. Is it possible that my back is pressing on something which is causing this urge to urinate?